DAVID JOHNSON
Dependent on policy B04M000483
Claims
2
Attributed to this person
Charged
974.00
Total submitted
Denied
91.00
1 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | DAVID JOHNSON |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000483 |
| Date of birth | 4 May 2003 |
| Plan | GOLD PPO |
| Covered from | 14 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002067 | 2 Jan 2026 | 883.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002066 | 15 Apr 2025 | 91.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 91.00 |